Northern Illinois Counseling Associates, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-004053 Issued in IL

Legal business name

NORTHERN ILLINOIS COUNSELING ASSOCIATES, P.C.

Practice address

600 Spring Hill Ring Rd Ste 116
West Dundee, IL 60118-7301

Phone

(815) 455-6736

Fax

(815) 455-9477

NPI assigned

Oct 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cynthia Gelman

Title

Director of Operations

Phone

(815) 455-6736

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• NICA Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn B Gelman, PSY.D.

  • Clinical Psychologist
  • Crystal Lake, IL
  • NPI 1487736690
  Medicare reassignment Care Compare group NPD
• Larry B Gelman, PSY.D.

  • Clinical Psychologist
  • Crystal Lake, IL
  • NPI 1902988215
  Medicare reassignment Care Compare group
• Brenda J Nemeth, LCSW

  • Clinical Social Worker
  • Crystal Lake, IL
  • NPI 1164504379
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1689862807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SPRING HILL RING RD STE 116",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601187301",
            "telephone_number": "815-455-6736",
            "fax_number": "815-455-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SPRING HILL RING RD STE 116",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "601187301",
            "telephone_number": "815-455-6736",
            "fax_number": "815-455-9477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4907 Shady Oaks Ln",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600121926",
            "country_code": "US",
            "telephone_number": "815-455-6736",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Garden Dr",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601240213",
            "country_code": "US",
            "telephone_number": "815-455-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS COUNSELING ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "GELMAN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "815-455-6736",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004053",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-003663",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0005615149",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NICA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "NICA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in West Dundee, IL
• Providers in West Dundee, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.